eprintid: 10190215
rev_number: 9
eprint_status: archive
userid: 699
dir: disk0/10/19/02/15
datestamp: 2024-04-09 13:47:39
lastmod: 2024-04-09 13:47:39
status_changed: 2024-04-09 13:47:39
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Cozzi-Lepri, Alessandro
creators_name: Borghi, Vanni
creators_name: Rotundo, Salvatore
creators_name: Mariani, Bianca
creators_name: Ferrari, Anna
creators_name: Del Borgo, Cosmo
creators_name: Bai, Francesca
creators_name: Colletti, Pietro
creators_name: Miraglia, Piermauro
creators_name: Torti, Carlo
creators_name: Cattelan, Anna Maria
creators_name: Cenderello, Giovanni
creators_name: Berruti, Marco
creators_name: Tascini, Carlo
creators_name: Parruti, Giustino
creators_name: Coladonato, Simona
creators_name: Gori, Andrea
creators_name: Marchetti, Giulia
creators_name: Lichtner, Miriam
creators_name: Coppola, Luigi
creators_name: Sorace, Chiara
creators_name: D'Abramo, Alessandra
creators_name: Mazzotta, Valentina
creators_name: Guaraldi, Giovanni
creators_name: Franceschini, Erica
creators_name: Meschiari, Marianna
creators_name: Sarmati, Loredana
creators_name: Antinori, Andrea
creators_name: Nicastri, Emanuele
creators_name: Mussini, Cristina
title: Development and validation of a prediction score for failure to casirivimab/imdevimab in hospitalized patients with COVID-19 pneumonia
ispublished: pub
divisions: UCL
divisions: B02
divisions: D01
divisions: G16
keywords: casirivimab/imdevimab, COVID-19, mechanical ventilation, mortality, prediction score, SARS-CoV-2
note: © 2024 the Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/).
abstract: INTRODUCTION: Casirivimab and imdevimab (CAS/IMV) are two non-competing, high-affinity human IgG1 anti-SARS-CoV-2 monoclonal antibodies, that showed a survival benefit in seronegative hospitalized patients with COVID-19. This study aimed to estimate the day-28 risk of mechanical ventilation (MV) and death in individuals hospitalized for severe COVID-19 pneumonia and receiving CAS/IMV. Additionally, it aimed to identify variables measured at the time of hospital admission that could predict these outcomes and derive a prediction algorithm. METHODS: This is a retrospective, observational cohort study conducted in 12 hospitals in Italy. Adult patients who were consecutively hospitalized from November 2021 to February 2022 receiving CAS/IMV were included. A multivariable logistic regression model was used to identify predictors of MV or death by day 28 from treatment initiation, and β-coefficients from the model were used to develop a risk score that was derived by means of leave-one-out internal cross-validation (CV), external CV, and calibration. Secondary outcome was mortality. RESULTS: A total of 480 hospitalized patients in the training set and 157 patients in the test set were included. By day 28, 36 participants (8%) underwent MV and 28 died (6%) for a total of 58 participants (12%) experiencing the composite primary endpoint. In multivariable analysis, four factors [age, PaO2/FiO2 ratio, lactate dehydrogenase (LDH), and platelets] were independently associated with the risk of MV/death and were used to generate the proposed risk score. The accuracy of the score in the area under the curve (AUC) was 0.80 and 0.77 in internal validation and test for the composite endpoint and 0.87 and 0.86 for death, respectively. The model also appeared to be well calibrated with the raw data. CONCLUSION: The mortality risk reported in our study was lower than that previously reported. Although CAS/IMV is no longer used, our score might help in identifying which patients are not likely to benefit from monoclonal antibodies and may require alternative interventions.
date: 2024
date_type: published
publisher: FRONTIERS MEDIA SA
official_url: http://dx.doi.org/10.3389/fmed.2024.1293431
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 2263748
doi: 10.3389/fmed.2024.1293431
medium: Electronic-eCollection
lyricists_name: Cozzi-Lepri, Alessandro
lyricists_id: ACOZZ70
actors_name: Cozzi-Lepri, Alessandro
actors_id: ACOZZ70
actors_role: owner
full_text_status: public
publication: Frontiers in Medicine
volume: 11
article_number: 1293431
pages: 9
event_location: Switzerland
citation:        Cozzi-Lepri, Alessandro;    Borghi, Vanni;    Rotundo, Salvatore;    Mariani, Bianca;    Ferrari, Anna;    Del Borgo, Cosmo;    Bai, Francesca;                                                                                             ... Mussini, Cristina; + view all <#>        Cozzi-Lepri, Alessandro;  Borghi, Vanni;  Rotundo, Salvatore;  Mariani, Bianca;  Ferrari, Anna;  Del Borgo, Cosmo;  Bai, Francesca;  Colletti, Pietro;  Miraglia, Piermauro;  Torti, Carlo;  Cattelan, Anna Maria;  Cenderello, Giovanni;  Berruti, Marco;  Tascini, Carlo;  Parruti, Giustino;  Coladonato, Simona;  Gori, Andrea;  Marchetti, Giulia;  Lichtner, Miriam;  Coppola, Luigi;  Sorace, Chiara;  D'Abramo, Alessandra;  Mazzotta, Valentina;  Guaraldi, Giovanni;  Franceschini, Erica;  Meschiari, Marianna;  Sarmati, Loredana;  Antinori, Andrea;  Nicastri, Emanuele;  Mussini, Cristina;   - view fewer <#>    (2024)    Development and validation of a prediction score for failure to casirivimab/imdevimab in hospitalized patients with COVID-19 pneumonia.                   Frontiers in Medicine , 11     , Article 1293431.  10.3389/fmed.2024.1293431 <https://doi.org/10.3389/fmed.2024.1293431>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10190215/2/Cozzi-Lepri_Development%20and%20validation%20of%20a%20prediction%20score%20for%20failure%20to%20casirivimab_imdevimab%20in%20hospitalized%20patients%20with%20COVID-19%20pneumonia_VoR.pdf